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Effect of Alternating Postures on Cognitive Performance

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ClinicalTrials.gov Identifier: NCT02863731
Recruitment Status : Completed
First Posted : August 11, 2016
Last Update Posted : August 17, 2016
Sponsor:
Collaborator:
University of Vienna
Information provided by (Responsible Party):
Bernhard Schwartz, University of Applied Sciences Upper Austria

Brief Summary:
Prolonged sitting is a risk factor for cardiovascular and musculoskeletal diseases, diabetes, several types of cancer and all-cause mortality. In combination with static and awkward postures, the prevalence of musculoskeletal diseases can increase further. Although the implementation of sit-to-stand or active workstations can help to reduce sitting time, improve physical activity at work and promote health benefits, it might also lead to changes in cognitive functions such as productivity. The purpose of this study is to evaluate the short-term effect of alternating working postures on cognitive performance for healthy people.

Condition or disease Intervention/treatment Phase
Sedentary Lifestyle Other: Alternating working postures, first day Other: Alternating working postures, second day Not Applicable

Detailed Description:

Measurements were made in a laboratory. They were made on two different days with an interval of 7 days between sessions. Laboratory tests were conducted in a controlled, simulated work-space located at the University of Applied Sciences Campus Linz. All laboratory measurements were made in a controlled laboratory at the campus site Linz of the University of Applied Sciences Upper Austria. Temperature, air flow, humidity, lighting conditions (artificial light only) and noise level were controlled and set to be consistent with the subjects' typical working environment.

During the laboratory measurements, subjects either stood or sat upright in an ergonomic office chair, according to the study protocol. Subjects were encouraged to work as fast and as accurately as they could. To ensure identical testing conditions between subjects and to not unduly influence physiological parameters such as heart rate variability (HRV), subjects were required to minimize excessive movement (e.g. standing up during the sitting periods).

In the first (initial) phase participants were familiarized with the study protocol. Sitting time and weekly physical activity were determined via the long version of the International Physical Activity Questionnaire (IPAQ, only on the first day of measurement). Examples of each cognitive test implemented in the cognitive phase were executed according to their guidelines. A 30 minute break in a sitting posture was used to ascertain baseline heart-rate level. Baseline heart-rate was calculated after a 20 minute rest for a 5 minute interval.

In the second (cognitive) phase subjects participated in a test battery containing five blocks. Each block consisted of a working speed test (text editing task), an attentional test (d2R-test of attention) and a reaction time test (Stroop-test). These tests lasted for 30 minutes to fulfill recommendations regarding postural changes. To simulate "common" working conditions (computer based and non-computer based tasks), digital (text editing task, Stroop-test) as well as pen & paper (d2R-test) versions of the implemented tests were used.

For the intervention group, the cognitive blocks were executed in an alternating posture (sit - stand - sit - stand - sit) either on the first or the second day of measurement (cross-over design). To generate control periods, this procedure was executed in an sitting posture only (sit - sit - sit - sit - sit) for the non-interventional day. For the control group, both days of measurement were executed in sitting posture only (sit - sit - sit - sit - sit ).

In the third (final) phase participants were asked to estimate their workload by means of the Task Load Index questionnaire developed by the National Aeronautics and Space Administration (NASA-TLX), followed by a 30 minutes resting phase in a sitting posture. During both 30 min resting phases (initial & final) participants watched documentaries and were encouraged not to talk.

Heart-rate and trunk movements were measured from the start of the study protocol until the next morning by means of an mobile ECG-recorder.


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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 46 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)
Official Title: Effect of Alternating Postures on Cognitive Performance
Study Start Date : January 2014
Actual Primary Completion Date : March 2015
Actual Study Completion Date : March 2015

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Alternating postures: first day
Alternating body postures on the first day of measurement. Sitting body posture on the second day of measurement.
Other: Alternating working postures, first day
On the first day of measurement participants execute five test battery trials in alternating postures (sit/stand/sit/stand/sit). On the second day of measurement participants execute the test battery in a sitting posture (sit/sit/sit/sit/sit).

Experimental: Alternating postures: second day
Alternating body postures on the second day of measurement. Sitting body posture on the first day of measurement.
Other: Alternating working postures, second day
On the first day of measurement participants execute five test battery trials in a sitting posture (sit/sit/sit/sit/sit). On the second day of measurement participants execute the test battery in alternating postures (sit/stand/sit/stand/sit).

No Intervention: Control group
Sitting body posture on both days of measurement.



Primary Outcome Measures :
  1. Reaction time [ Time Frame: 2 experimental days ]

    Reaction time is a commonly measured parameter to describe mental states, fatigue or performance in ergonomic research. As the effect of alternating postures on reaction time is still unclear, a digital version of the Color-Word-Conflict-Stroop-Test has been implemented.

    It contained 190 congruent, incongruent and neutral tasks and required approximately 10 min to simulate long-lasting monotonous office screen work. The reaction time was measured and recorded automatically. Outliers (values outside of the limits of 3 standard deviations) have been automatically eliminated. The Stroop-Test is characterized by a high test-retest reliability.

    Due to the cross-over design of the study two days were necessary to determine the interventional effect. According to the group allocation the participants executed the Stroop-test either in an alternating or sitting posture. Differences in reaction time and accuracy between "alternating" and "sitting" days will be analyzed.


  2. Attentional performance [ Time Frame: 2 experimental days ]

    As the effect of alternating postures on attentional performance is still unclear, an attentional performance test called "d2R-test of attention" has been implemented. The d2R-test was executed as a pen and paper version. Therefore, it enabled screen breaks during the test protocol and simulated paper-related office work. The d2R-Test is characterized by a high test-retest reliability and do not require any specific previous knowledge except of rudimentary language skills. Normative values for the d2R-test are available for different countries.

    Attentional performance and accuracy were manually determined according to the d2R-guidelines.

    Due to the cross-over design of the study two days were necessary to determine the interventional effect. According to the group allocation the participants executed the d2R-test either in an alternating or sitting posture. Differences in attentional performance and accuracy between "alternating" and "sitting" days will be analyzed.


  3. Working speed [ Time Frame: 2 experimental days ]

    Physical efforts when performing standardized tests (e.g. standing or walking) can negatively influence cognitive parameters as well as working speed. To determine the effect of alternating postures on working speed a digital text editing task encouraging participants to fill in spaces in an ergonomic guideline text for 10 min was used.

    Working speed (words per minute) and accuracy (relative error) have been manually calculated.

    Due to the cross-over design of the study two days were necessary to determine the interventional effect. According to the group allocation the participants executed the text editing task either in an alternating or sitting posture. Differences in working speed between "alternating" and "sitting" days will be analyzed.


  4. Workload perception [ Time Frame: 2 experimental days ]

    Sit-to-stand workstations can evoke positive as well as negative associations. A common method to rate workload perception is the NASA-TLX questionnaire (Task Load Index, National Aeronautics and Space Administration). For reasons of simplicity and unmodified sensitivity, the short version of this questionnaire (RTLX, raw task load index), consisting of six major items, was used. Influences on workload perception based on unweighted items in the RTLX were negated due to the cross-over design.

    Due to the cross-over design of the study two days were necessary to determine the interventional effect. According to the group allocation the participants scored their perceived workload after executing several cognitive tests in an alternating or sitting posture. Differences in workload perception between "alternating" and "sitting" days will be analyzed.



Other Outcome Measures:
  1. Body movements [ Time Frame: 2 experimental days ]
    Body movements can alter physiological parameters and cognitive performance. Especially small movements during longer time intervals are very hard to classify by means of personal observations. Therefore, a three-dimensional accelerometer - placed on the sternum via a neoprene breast belt - was used to objectively measure body movements. Upper body placements of accelerometers have been shown to reliably detect body movements, and sit-to-stand as well as stand-to-sit transitions. To reduce the total number of sensors, a HRV-recorder with integrated 3D-accelerometer was used.



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 39 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Healthy Caucasian (no acute or chronic diseases)
  • Normal weight or overweight (BMI: 18.5 - 30.0 kg/m²)
  • Regular computer users
  • Fluent German speakers
  • Consented to participate

Exclusion Criteria:

  • Obesity (BMI > 30.0 kg/m²)
  • Experience in sit-to-stand workstations
  • Acute or chronic diseases
  • Inability to stand
  • Visual impairments that had not been corrected
  • Color blindness
  • Regular heavy smokers (> 10 cigarettes /day)
  • Not consented to participate

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02863731


Locations
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Austria
University of Applied Sciences Upper Austria
Linz, Upper Austria, Austria, 4020
Sponsors and Collaborators
University of Applied Sciences Upper Austria
University of Vienna
Investigators
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Study Director: Bernhard Schwartz, MSc University of Applied Sciences Upper Austria

Publications:

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Bernhard Schwartz, Research Associate, University of Applied Sciences Upper Austria
ClinicalTrials.gov Identifier: NCT02863731     History of Changes
Other Study ID Numbers: AO-8735-2
834185 ( Other Grant/Funding Number: Austrian Research Promotion Agency (FFG) )
First Posted: August 11, 2016    Key Record Dates
Last Update Posted: August 17, 2016
Last Verified: August 2016
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Keywords provided by Bernhard Schwartz, University of Applied Sciences Upper Austria:
postural changes
alternating postures
Cognitive performance
Height-adjustable desk
Worksite